Surgical treatment of atrial fibrillation recently gained new popularity since the introduction of different energy sources as an alternative to the original cut-and-sew technique. Recently an innovative approach for closed-chest thoracoscopic epicardial pulmonary veins isolation has been described for patients suffering from lone atrial fibrillation. Nevertheless in an effort to further reduce the invasiveness of closed-chest atrial fibrillation surgery, we developed a novel monolateral approach for thoracoscopic arrhythmia surgery.